Objective To compare the efficacies and indications of locking compression plate (LCP) and external fixator plus Kirschner wires in treatment of complex intra-articular fracture of the dis-tal radius. Methods Ninety-eight patients with complex intra-articular fractures of the distal radius were treated with volar LCP or external fixator plus Kirschner wires, the efficacies of which were evaluated by comparing the grasping force and wrist function of the patients. Results All the patients were fol-lowed up for an average of 12.4 months, which showed fracture healing in all the patients. According to the wrist function assessment system of New York Orthopedic Hospital (1990), there was no statistical difference in the efficacy of LCP and external f'lxator plus Kirschner wires in treatment of types C1 or C2 fractures (P > 0.05), while the efficacy of external fixator plus Kirschner wires was significantly superior to that of LCP in treating type C3 fracture (P < 0.05). Conclusions For types C1 or C2 intra-articu-lar fractures of the distal radius, the efficacies of LCP and external fixator plus Kirschner wires are simi-lar, while the efficacy of external fixator plus Kirschner wires is superior to that of LCP in treating type C3 intra-articular fracture of the distal radius.

To explore the prevalence and risk factors of depression in low-vision elder patients aged 60-85 years residing at Beizhuang Township,Miyun county.The activity of daily living scale (ADL) and geriatric depression scale (GDS) were used for diagnosis and grade the severity of depression.The prevalence rate of depression was higher in low-vision patients (36.2％) than in the control group (15.5％,P ＜0.05).The need for assistance in daily activities was higher in low-vision patients than in the control group(x2 =13.57,P ＜0.01).Patients with good economic conditions,being cared by relatives and living with their spouse had lower levels of ADL and GDS (all P ＜ 0.05).

OBJECTIVETo investigate the clinical effect of repairing soft tissue defect after hand wound using reverse island skin flap of upper carpal cutaneous branches of ulnar artery.

METHODSFrom June 2010 to November 2016, 12 patients with hand soft tissue defects were repaired by reverse island skin flap of upper carpal cutaneous branches of ulnar artery, including 9 males and 3 females with an average age of (35.2±9.4) years old ranging from 22 to 58 years. The defect area varied from 7.0 cm×3.0 cm to 12.0 cm×7.0 cm. Time interval from injury to operation ranged from 3 to 15 days with an average of (8.4±2.6) days. The flap was designed beforehand according to the size of the defect, sharply dissected the aponeurotic fascia from the proximal to the distal, abscised the communicating branch between the flap and the ulnar artery at the wrist epithelial branch, repairing the defect of flap with method of metastasis retrograde. The sensation, shape of the flap and hand function were observed, and the upper extremity function was evaluated according to the standard of hand surgery branch from Chinese Medical Association to assessment of functional recovery.

RESULTSThe flaps in 10 patients obtained primary healing, the healed time was 14 to 18 days with an average of(15.0±1.5) days. Two patients occurred distal flap necrosis, and wound surface healed after change dressing and skingrafting cover. All patients were followed up from 3 to 15 months with an average of(7.0±3.8) months. According to the upper extremity functional evaluation standard by hand surgery branch of Chinese Medical Association, 2 cases got excellent results, 7 good, 2 fair and 1 poor.

CONCLUSIONSReverse island skin flap of upper carpal cutaneous branches of ulnar artery for the treatment of soft tissue defect caused by hand wound has advantages of concealed donor area, no need sacrifice the main blood vessel, flap thin and no need repair it for thick and thin.

OBJECTIVETo evaluate the rate of residual disease in the thyroid gland and rate of cervical lymph node metastasis after preliminary local resections in thyroid cancer.

METHODSFrom 1994 - 1999, 160 thyroid cancer patients who had previously been treated with nodulectomy or subtotal lobectomy in other hospitals were reoperated.

RESULTSThe rate of residual disease at the primary site was 42.5%. The lymph node metastatic rate at level VI was 28.1%. The rate of lymph node metastasis in those with enlarged lymph nodes in the ipsilateral internal jugular chain was 35.4%. The rate of laryngeal recurrent nerve injury was 12.5% at the first operation which is much higher than that of the second operation (1.9%).

CONCLUSIONBecause of the high rate of local residual disease, nodulectomy or subtotal lobectomy alone is not indicated for thyroid cancer. The exploration to level VI is needed for thyroid cancer. It is of utmost importance to be familiar with laryngeal recurrent nerve anatomy in thyroid surgery.

Adult ; Female ; Humans ; Male ; Neoplasm Recurrence, Local ; surgery ; Neoplasm, Residual ; surgery ; Thyroid Gland ; pathology ; surgery ; Thyroid Neoplasms ; surgery ; Thyroidectomy

OBJECTIVETo study the methylation status of fragile histidine triad (FHIT) gene promoter in patients with myelodysplastic syndrome (MDS) and its clinical relevance.

METHODSMethylation-specific PCR (MSP) was used to detect FHIT promoter methylation in bone marrow samples from 54 MDS cases.

RESULTSHypermethylation of FHIT promoter was detected in 26 cases (48.1%). Association was not found between FHIT gene hypermethylation and sex, hematologic parameters and chromosomal abnormalities of MDS patients, but found between FHIT gene hypermethylation and age of the MDS cases. Although significant difference was not observed in the frequencies of FHIT gene hypermethylation among patients with refractory anemia/refractory anemia with ringed sideroblasts (RA/RAS) (1/6, 16.7%), refractory anemia/refractory anemia with ringed sideroblasts (RCMD) and refractory cytopenia with multilineage dysplasia with ringed blasts (RCMD-RS) (6/19, 31.6%), refractory anemia with excess blasts-1 (RAEB-1) (7/11, 63.6%), refractory anemia with excess blasts-2 (RAEB-2) (4/7, 57.1%) and refractory anemia with excess blasts in transformation/acute myeloid leukemia (RAEBt/AML) (8/11, 72.7%)(chi-square=8.417, P=0.077), it was observed in patients in early stages (RA/RAS and RCMD) (7/25, 28.0%), advanced stages (RAEB-1 and RAEB-2)(11/18, 61.1%) and RAEBt/AML (8/11, 72.7%) (chi-square=7.938, P=0.019). Furthermore, there was a positive correlation between the frequency of FHIT gene hypermethylation and different IPSS groups (chi-square=10.110, P=0.018).

CONCLUSIONFHIT gene hypermethylation might be one of the molecular events involved in the disease progression of MDS.

Acid Anhydride Hydrolases ; genetics ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Base Sequence ; DNA Methylation ; Female ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Myelodysplastic Syndromes ; classification ; genetics ; pathology ; Neoplasm Proteins ; genetics ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; genetics

OBJECTIVE：To study the inhibi tory effects of genistein on the growth of human nasopharyngeal carcinoma. CNE 1 cells and predict its potential target. METHODS ：CCK-8 method was used to test the effects of 0（blank control ），12.5，25，50， 100，150 µmol/L genistein on the proliferation of CNE 1 cells after treated for 24，48，72 h. Flow cytometry was carried out to detect the effects of 0（blank control ），15，30，60 µmol/L genistein on the cell cycle and ap optosis of CNE 1 cells after treated for 24 h. Scratch test was used to investigate the effects of 0（blank control ）， 10， 20， 30 µmol/L genistein on themigration ability of CNE 1 cells after treated for 24 h. High （No.18210156） throughput sequencing was conducted to discover the differential genes in CNE 1 cells after treated with 0（blankcontrol），30 µmol/L genistein for 24 h. RT-qPCR assay was adopted to verify the mRNA expression of related differential genes in above trials. RESULTS ： Compared with blank control，12.5，25，50，100，150 µmol/L genistein sho wed significant inhibitory effect on the proliferation of CNE 1 cells（P＜ 0.01），in a concentration- time-effect manner ；15，30 µmol/L genistein could arrest CNE 1 cell cycle at G 0/G1 stage（P＜0.05 or P＜ 0.01）；30，60 µmol/L could arrest CNE 1 cell cycle at G 2/M stage and promoted cell apoptosis （P＜0.05 or P＜0.01）. 10，20，30 µmol/L genistein could significantly inhibit the migration ability of CNE 1 cells（padj＜0.01）. High throughput sequencing revealed a total of 2 271 differentialgenes（P＜0.05），1 154 of which were up-regulated while 1 117 of which were down-regulated ；8 potential target genes ，including p53，p21，STC2，FGF2，CDK6，CYCLIN D ，PI3K，AKT，were screened by cell experiment. After validated by RT-qPCR assay ，mRNA expression of p53，p21，STC2，FGF2，CDK6，CYCLIN D and AKT were significantly down-regulated（P＜0.05），which consistent with the sequencing results. CONCLUSIONS ：Genistein can effectively inhibit the growth of human nasopharyngeal carcinoma CNE 1 cells，the mechanism of which may associated with inhibiting the expression of mutant gene p53，restoring the function of wild-type P 53 protein and inhibiting the activity of PI 3K/Akt pathway.

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.